Aggression during the course of the pregnancy can take different forms: societal and parental, but the medical community also contributes. First of all, there is verbal violence. As the desire to conceive during adolescence is viewed negatively, the pregnancy is often defined as a failure of contraception and it is usually boiled down to a risk that must be avoided at all costs. Sometimes, verbal violence is represented by the use of terms such as an ‘epidemic of pregnancies’.
These pregnancies are also the source of internal violence: the teenager will be subjected to the full fury of this so-called accidental or surprise pregnancy.
She is confronted with a sexuality that she did not really want to face and the collapse of her childlike feelings of power that rendered her invulnerable.
Under these conditions, denial of the pregnancy is considered a defensive refuge of a body inhabited by an alien presence. Moreover, these are the pregnancies that are discovered late and are the source of serious conflict. Finally, this pregnancy forces the young woman to confront her ambivalence, which is not the least of her sufferance, enhanced by the culpability of having transgressed a clearly marked boundary.
Some pregnancies result from sexual aggression, either forced incestuous relationships or distress in response to the reconciliation of a falling out, or sometimes from the recovery from depression which gives a reason to live and repair her body. These young women have an immense hunger for love and recognition that they hope to fulfill with their child. Some abortions can be the equivalents of true suicides. The presumed date of delivery of the interrupted pregnancy may serve as the time for commemorative suicide attempts, signaling the pain, the unachieved mourning and the emptiness that are difficult to overcome.
The aggression can also be physical, within the familial entourage: assault and battery, verbal attacks, insults and/or expulsion from home. In some families, the teenager who announces her pregnancy may be putting her life on the line and find herself forced to abort or risk the life of her future newborn.
One of the roles of the doctor is to sometimes serve as a mediator between the adolescent and her parents. It is not unusual that a mother’s violence is associated with a painful episode in her own life which is reactivated by the pregnancy of her daughter.
Aggression can also occur in institutional environments, more precisely in school, because it is not unusual to see these young women subjected to degrading measures and relegated to the back of the room, where the sensation of isolation is even more accentuated.
Finally, we must emphasize the risk of aggression by the medical community because this pregnancy forces it to confront its own failure to prevent conception.
It can lead to an abortion performed in a climate of verbal aggressiveness when the young patient’s consent is not necessarily sought.
Choquet and Ledoux investigated French teenagers 12–19 years old and found 15% had been the object of physical violence, 8% had been physically wounded, 3.8% were the targets of sexual violence and 1% had been raped.
In our medico-legal unit in Seine-Saint-Denis, we recorded between 1990 and 1998 increased abuse of and sexual aggression against minors of both sexes (table 2). These rises may be attributable to the increased ferocity of violence in the suburbs but may also represent the better reporting and recording of events that previously fell by the wayside. Whichever the case, these findings are most disquieting.
Revision date: June 14, 2011
Last revised: by Andrew G. Epstein, M.D.